Using latent trait modeling to conceptualize an alcohol problems continuum

Recent research points toward the viability of conceptualizing alcohol problems as arrayed along a continuum. Nevertheless, modern statistical techniques designed to scale multiple problems along a continuum (latent trait modeling; LTM) have rarely been applied to alcohol problems. This study applies LTM methods to data on 110 problems reported during in-person interviews of 1,348 middle-aged men (mean age=43) from the general population. The results revealed a continuum of severity linking the 110 problems, ranging from heavy and abusive drinking, through tolerance and withdrawal, to serious complications of alcoholism. These results indicate that alcohol problems can be arrayed along a dimension of severity and emphasize the relevance of LTM to informing the conceptualization and assessment of alcohol problems.     

Differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self-harm and personality disturbance: the POPMACT study

A total of 480 patients were treated in a large, multicenter randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behavior therapy (MACT) versus treatment as usual (TAU) for recurrent deliberate self-harm. Each patient was randomized after a self-harm episode assessed at an accident and emergency center and followed up over 1 year. The main hypothesis tested was that those allocated to MACT would have a lower proportion of self-harm episodes in the succeeding year. A total of 60% of those allocated to MACT had face-to-face treatment and 430 (90%) of all patients had self-harm data recorded after 1 year. Although the results showed no significant difference between those repeating self-harm in the MACT group (39%) compared with the TAU group (46%) (P = 0.20), the treatment was cost effective (10% cheaper than TAU) and the frequency of self-harm episodes was fewer (50%) in the MACT group. A total of nine of 10 patients had some personality disturbance (42% of these with disorder), and for those where information on parasuicide events was collected, the proportion having a repeat episode ranged from 33% to 63% for different personality disorders. Those with BPD were most likely to repeat episodes quickly (mean 89 days for 25% to repeat) with dissocial personality disorder (equivalent mean 384 days) the slowest to repeat. Total costs were significantly greater in those with personality disorder and were reduced in those allocated to MACT; this saving was reversed in those with borderline disorder. On average, MACT appeared to increase the cost of those patients with BPD (BPD) and reduce the cost of those with other personality disorders. It is concluded that MACT has value in preventing self-harm cost effectively but this appears to be confined mainly to those who do not have BPD.     

An analysis of post-booking jail diversion programming for persons with co-occurring disorders

For persons with co-occurring disorders, interaction with criminal justice systems is a frequent occurrence. As a result, a variety of diversionary programs have been developed nationwide. In this study, a total of 248 individuals with co-occurring disorders of serious mental illness and substance use disorders who had been arrested and booked on misdemeanor charges participated in a post-booking jail diversion program in two urban communities. A quasi-experimental design was used with individuals assigned to diversion or non-diversion status based upon the decision processes of the mental health-criminal justice systems. The effectiveness of the jail diversion program was evaluated from a variety of sources, including structured interviews, behavioral health service utilization patterns, and criminal justice recidivism patterns. Analyses revealed general main effects for time on many of the outcome variables, with few main effects or interaction effects detected on the basis of diversion status (diverted versus non-diverted). Across all measures assessing mental health and substance abuse, study participants displayed improvements over time, irrespective of their diversion status or program location. Participants generally displayed no significant changes in their rates of accessibility to, or frequency of use of, the various mental health, substance abuse, and other services, and few changes for diversion status were detected with regard to service utilization. Although a number of indicators of criminality and violence were reduced over time, these reductions were statistically insignificant, with changes for diversionary status or time identified at follow-up. These results are discussed in light of their implications for jail diversion programming and future research in this area.     

Vicarious responses to pain in anterior cingulate cortex: Is empathy a multisensory issue?

Results obtained with functional magnetic resonance imaging show that both feeling a moderately painful pinprick stimulus to the fingertips and witnessing another person’s hand undergo similar stimulation are associated with common activity in a pain-related area in the right dorsal anterior cingulate cortex (ACC). Common activity in response to noxious tactile and visual stimulation was restricted to the right inferior Brodmann’s area 24b. These results suggest a shared neural substrate for felt and seen pain for aversive ecological events happening to strangers and in the absence of overt symbolic cues. In contrast to ACC 24b, the primary somatosensory cortex showed significant activations in response to both noxious and innocuous tactile, but not visual, stimuli. The different response patterns in the two areas are consistent with the ACC’s role in coding the motivational-affective dimension of pain, which is associated with the preparation of behavioral responses to aversive events.     

Orienting in space and time: Joint contributions to exogenous spatial cuing effects

We examined whether the time course of exogenous spatial-cuing effects is sensitive to the allocation of attention in time. Expectation for a target within a particular time window following the cue was manipulated by varying the proportion of trials that appeared at each of three stimulus onset asynchronies in both a detection task and a two-alternative forced-choice discrimination task. The time course of spatial-cuing effects was sensitive to the temporal expectation manipulation only in the discrimination task. The results are discussed with reference to the role of attentional set in exogenous spatialcuing paradigms.     

Treatment efficacy of noncontingent reinforcement during brief and extended application

We evaluated the long-term therapeutic effects of noncontingent reinforcement (NCR). In Experiment 1, NCR effects were examined with 2 participants' arbitrary responses; in Experiment 2, NCR was used as treatment with 3 participants whose self-injurious behavior (SIB) was maintained by automatic reinforcement. In both experiments, NCR consisted of continuous access to a highly preferred leisure item and was implemented initially during 10-min and later during 120-min sessions. Varied reinforcers (leisure items) were subsequently introduced during 120-min sessions to determine if treatment effects might be extended. Finally (Experiment 2 only), NCR was implemented throughout the day in participants' homes. Results of Experiments 1 and 2 showed that reinforcers obtained through object manipulation can compete with those obtained automatically by engaging in SIB during brief NCR sessions. However, data from the 120-min sessions indicated that satiation to a specific leisure item might occur over periods of time more typical of those during which treatment would be implemented. Access to a variety of highly preferred leisure items extended the effectiveness of NCR for some individuals. When NCR was implemented throughout the day (Experiment 2), therapeutic effects were shown to be maintained for up to 1 year.     

Numerity of a socially housed hamadryas baboon (Papio hamadryas) and a socially housed squirrel monkey (Saimiri sciureus)

To extend a study conducted by E. M. Brannon and H. S. Terrace (1998, 2000), the authors trained 1 hamadryas baboon (Papio hamadryas) and 1 squirrel monkey (Saimiri sciureus) to respond to stimuli representing the numerosities 1-4 in ascending order. When tested with novel stimuli of the same numerosities, both subjects' performance appeared to be based on the numerical attributes of stimuli. Subjects were then tested on their ability to order pairs of numerosities derived from the values 1-9. Both subjects successfully ordered pairs that included the untrained numerosities 5-9 regardless of the total surface area of numerosities. Accuracy and latency of responding also showed numerical distance and magnitude effects. Numerosity was a salient cue to both subjects, suggesting that these 2 families of primates perceive ordinal relations. The outcome shows that cognitive studies of this type can be effectively conducted with socially housed animals.     

The Tripartite Model of Neuroticism and the suppression of depression and anxiety within an escalation of commitment dilemma

We found evidence of a mutual suppression effect between anxiety and depression on an individual's level of commitment within escalation dilemmas. On the one hand, our results demonstrate a positive relationship between anxiety and level of commitment; on the other, our results demonstrate a negative relationship between depression and level of commitment. Based on the opposing relationships between anxiety and depression and commitment, the broad factor of neuroticism does not demonstrate any relationship with level of commitment, and the significant effects of anxiety and depression on commitment is contingent upon partialling the effect of the other facet of neuroticism. Thus, we contend that applied psychologists, who have focused on neuroticism as a broad construct, should consider the large body of work among clinical psychologists, who argue that anxiety and depression have unique variance associated with them. We conclude by addressing organizational implications of measuring the broad trait of neuroticism more narrowly.     

Effects of a carbohydrate-restricted diet on affective responses to acute exercise among physically active participants

Currently, the carbohydrate-restricted diet is very popular. Atkins' book, Dr. Atkins' Diet Revolution, has sold millions in its more than 25 years of existence. His book promotes the carbohydrate-restricted diet, which focuses on the consumption of proteins and fats as primary calorie and energy sources, while severely restricting carbohydrates. However, when carbohydrates are restricted from the diet, the body's primary energy source is reduced considerably. Therefore, the purpose of this study was to compare the psychological responses to exercise of individuals when on a carbohydrate restrictive diet and when on a noncarbohydrate restrictive diet. For this study, 17 participants practiced a noncarbohydrate-restricted diet for three weeks and the carbohydrate-restricted diet for three weeks, while maintaining previous exercise habits. After each exercise session, the participants completed the Physical Activity Affect Scale, which measures Positive Affect, Negative Affect, Tranquility, and Fatigue. Simple one-way analyses of variance indicated significant treatment differences (ps<.05) relative to Negative Affect, Positive Affect, and Fatigue. The results of the study indicate as predicted, that, when a person restricts carbohydrates from the diet, he will experience more fatigue, more negative affect, and less positive affect in response to exercise than those individuals who are not restricting carbohydrates.     

Forbidden knowledge

This case is part of a series of case studies used as an exercise within a program on research ethics education. The case involves research on genetic birth defects in a culturally distinct, closed religious community in which elders speak for the community. The case raises ethical issues of informed consent in such a setting; of collaboration with the community; of conflicts between the researchers’ responsibilities to the community as a whole and to individual subjects; of the impact of the researcher’s findings on the practices and values of the community and issues regarding how the researchers share findings with subjects and how the findings are stored.